Abstract: Described are implants, tools, and related methods, for use in pelvic surgery to treat conditions such as prolapse, including embodiments of methods that involve a tissue path above the arcus tendineus.

Abstract: Various embodiments of a pelvic treatment system and method are provided. The present invention can include one or more drug eluting darts or barbs that are lodged into the wall and will elute the drug over a desired time period (weeks, months for example) to treat OAB, BPH, tissue weaknesses, or other disorders or diseases.

Abstract: Described are devices, implants and kits for treating incontinence in a male or female. In particular an assembly comprising a multi-piece implant comprising a support portion piece (82) and two extension portion pieces (84) adjustably connected to the support portion piece, and an adjusting tool (92) to allow adjustment of extension portion pieces relative to the support portion piece, is described.

Abstract: An implantable article and method are disclosed for treating pelvic floor disorders such as vaginal vault prolase. A surgical kit useful for performing a surgical procedure such as a sacral colpopexy is also described.

Abstract: A surgical training system includes an anatomical training model, three or more telemetry sensors attached to the training model, a training tool, a display, and a controller. The anatomical training model physically simulates human anatomical features. The training tool comprises at least one transmitter configured to emit a signal. The controller includes one or more processors configured to determine a location of the training tool relative to the training model using the sensors in the signal, and produce a virtual image of the training tool and anatomical features simulated by the training model on the display based on the location of the training tool.

Abstract: Described are various embodiments of surgical procedures, systems, implants, devices, tools, and methods, useful for treating pelvic conditions in a male or female, the pelvic conditions including incontinence (various forms such as fecal incontinence, stress urinary incontinence, urge incontinence, mixed incontinence, etc.), vaginal prolapse (including various forms such as enterocele, cystocele, rectocele, apical or vault prolapse, uterine descent, etc.), and other conditions caused by muscle and ligament weakness, the devices and tools including devices and tools for anchoring an implant to tissue.

Abstract: An apparatus has a pump module providing pump energy, a resonator and a controller. The resonator includes a gain medium receiving the pump energy from the pump module and producing light; reflective surfaces reflecting light produced by the gain medium back toward the gain medium; and a variable light attenuator receiving light produced by the gain medium. The controller controls the amount of light attenuated by the variable light attenuator such that the apparatus emits windows of pulses of laser light at spaced time intervals, each window containing a plurality of pulses of laser light and each interval between windows being larger than an interval between pulses within a window. The emitted windows of pulses of laser light heat tissue to a temperature that causes coagulation without vaporization.

Abstract: Described are various embodiments of surgical procedures, systems, implants, devices, tools, and methods, useful for treating pelvic conditions in a male or female, the pelvic conditions including incontinence (various forms such as fecal incontinence, stress urinary incontinence, urge incontinence, mixed incontinence, etc.), vaginal prolapse (including various forms such as enterocele, cystocele, rectocele, apical or vault prolapse, uterine descent, etc.), and other conditions caused by muscle and ligament weakness, the devices and tools including devices and tools for anchoring an implant to supportive tissue and adjusting the implant.

Abstract: The invention relates to systems and therapeutic methods to reduce plaque causing Peyronie's disease. One approach uses high pressure injection of collagenase-containing composition into a penile plaque. Plaque disruption is enhanced by the mechanical force of the high pressure, followed by the enzymatic action of collagenase. Another approach uses collagenase as a pretreatment, followed by addition of adipose-derived stem cells ADSCs. The initial collagenase injection breaks down collagen (often more type III than type I in Peyronie's) to provide short term benefit. The longer-term benefit is provided by introduction of ADSCs to the plaque, which can produce cytokines and other signals for revascularization and restoration of normal penile tissue. The resulting combination advantageously reduces the bulk of the plaque early on with ongoing reduction through the revascularization of the tissue. In addition, the treatment provides an advantageous shift of elastin and collagen ratios.

Abstract: Described are methods of treating urinary incontinence using a urinary sling and a tissue path that passes through the obturator foramen, along with related surgical implants, devices, systems, and kits.

Abstract: An implantable electrical stimulation device configured to treat multiple pelvic conditions of a patient includes a pulse generator, memory, first and second electrode leads comprising one or more electrodes, a switch and a controller. The switch has a first state, in which the first electrode lead is electrically coupled to the pulse generator, and a second state, in which the second electrode lead is electrically coupled to the pulse generator. The controller includes at least one processor that is configured to execute at least one stimulation program stored in the memory. The controller is also configured to selectively set the switch in the first or second state. Electrical stimulation pulses generated by the pulse generator responsive to the execution of the stimulation program are delivered to the first or second electrode lead depending on the state of the switch.

Abstract: The present invention provides a urethral prosthesis including a first and a second arm that join to form a junction, and a stem that is also joined to the junction. The junction is adapted to exert sufficient pressure on a portion of a patient's urethra to prevent unintentional voiding of the patient's bladder. However, upon exerting a tension force on the stem, the pressure exerted by the junction is reduced such that the patient's bladder may be intentionally voided.

Abstract: The disclosure provides compositions, systems, and methods for the treatment of pelvic tissue conditions that include use of a silk fibroin-containing hydrogel composition. The composition includes water-soluble fibroin and a water-soluble crosslinkable polymer. The composition can be used as a pre-formed hydrogel or can be delivered to a pelvic tissue site and crosslinked in situ to form a hydrogel. The composition can be used to promote tissue closure, such as vaginal wound or fistula closure. The composition can also be used to enhance attachment or anchoring of a pelvic implant to a pelvic tissue. A hydrogel delivered to a pelvic tissue site, or formed at the site in situ, is associated with a portion of the implant (e.g., a mesh implant) via a tether or implant extension portion, thereby providing improved immobilization of the implant. Systems or kits that include the composition and a delivery needle or insertion tool are also described.

Abstract: Described are devices, systems, and combinations useful for monitoring tension in an implant, which may be an implant useful to treat a pelvic condition, the device, system, or combination including an implant and a tension indicator.

Abstract: A system for treating vaginal prolapse including two implants, each implant including a mesh support portion and two mesh extension portions, wherein for each implant the support portion is capable of contacting vaginal sulcus tissue while the two extension portions extend to tissue of an obturator foramen. The implant may include a mesh strip, with the support portion having a length between 4 and 6 centimeters, with the total length of the mesh strip being between 15 and 20 centimeters, and with the mesh strip being of substantially uniform width in the range from 0.5 to 1.3 centimeters. The implant may include two sutures, with one suture connected at each opposing end of the implant, and/or the implant may include one or multiple sutures connected along a length of the implant.

Abstract: A laser lithotripsy method for fragmenting a kidney or bladder stone in a patient is provided. The method includes delivering a first laser energy having a first wavelength to the stone. The stone is heated in response to the delivery of the first laser energy to the stone. The method also includes delivering a second laser energy to the stone having a second wavelength that has a higher absorption by the stone or the fluid surrounding the stone than the first wavelength. The stone is fragmented in response to the delivery of the second laser energy to the stone.

Abstract: A pelvic implant assembly (100) comprising a support portion (128) and an extension portion (124), a self-fixating tip (10, 120) connected to the extension portion, the self-fixating tip comprising a base (12) comprising a proximal base end (14) and a distal base end (16), the proximal base end being connected to the extension portion, the base comprising an internal channel (18) extending from the proximal base end and at least partially along a length of the base toward the distal base end, a fixed lateral extension (20) extending from the base.

Abstract: A needleless fluid injection system (100) including an injection console (102), an injection chamber in operative communication with the console, an injectate shaft (104) in operative communication with the console, which has an injection lumen extending from a proximal end to a distal end of the shaft, and at least one injection orifice extending through a wall of the injection lumen proximate the distal end of the shaft. The injection lumen can include a sealing cap (40) at its distal end.

Abstract: An implant or sling device is provided with a tension adjustment system. The adjustment system can include one or more small pressure bulbs placed against the inferior pubic rami for support. By palpating the bulbs (one on left and one on right), the pressure can be adjusted to control the tension of the implant. Other conduits, balloons, introduction tools, ports and fluid adjustment components and mechanisms can be included to provide selective adjustment of the tension of the implant relative to the supported tissue or organ.